May 27, 2011

Not now (not ever)

The other night as I put away our dinner's leftovers, Andy yelled down to me as he carried Roscoe from the tub into his room to get ready for bed, "If I ever die, I carry Roscoe in his towel like a sling, and call him a baby elephant or a baby whale."

I paused. "Um, okay?"

He responded, "Well, I just want you to know in case something ever happens to me. He really likes it."

Silence.

I thought for a minute, and then blurted out, "If I ever die, I want you to get remarried."

Long pause. "Hold on one second." Andy appeared at the foot of the stairs holding Roscoe in his arms. "What are you talking about? Why?"

"I wouldn't want the boys to grow up without a mother. I would want you to get remarried." He furrowed his brow, gave me a quick kiss, and said we'd talk later, then ascended the stairs and disappeared into the hallway leading to Roscoe's dimly lit room.

A few weeks ago I found a lump in my right breast. It was palpable and a little tender. The tenderness was familiar and I was worried because that meant it had been around for a while. Maybe even as early as those first days in the NICU with Merritt. On the upside, I thought it might be breastfeeding related.

I made an appointment for a few days later, and the nurse practitioner was confident that it was a plugged milk duct. So confident that I almost brushed off the suggested followup of an ultrasound, in part because of the inconvenience of Andy having to take off work since they don't allow kids at appointments.

But then I thought about my boys, and scheduled the ultrasound so that we could know for sure and move forward without any doubts.

Yesterday morning the four of us trooped to the Radiologist's and when my name was called I left Andy and the kids behind, anxious to confirm that this lump was nothing at all to be concerned about.

When she was finished, the tech said she'd be back in a second, the doctor needed to review the images. I remained on my back staring up at five large stickers of different colored cartoon cats and dogs stuck to the ceiling. With no clock in the room I gauged time by the number of pop songs that came through on the radio. About 5 1/2 of them. It had been too long, and I stuck my head out the door to see if I could flag anyone down.

My eyes locked with the patient waiting across from me. We exchanged sympathetic glances and I ducked back into my room to flip through magazines.

My mind wandered to Merritt who would undoubtedly need to nurse soon, and Roscoe who's lunchtime was also quickly approaching. I wished I had brought my cell phone to check in with Andy who was probably wondering what had happened to me.

Just then, a doctor entered the room with my tech following closely behind him. Uh oh.

He took a look for himself and then explained that the lump is structural and located outside of ducts. They can't rule out malignancy with ultrasound, so a biopsy was recommended. There are risks associated with biopsy in lactating women, the worst of which (in my opinion) is a post op requirement to refrain from nursing for 2 or 3 days afterward. Obviously, this would impact my supply. I had a lot of questions, and the doctor answered each of them, but I got the impression that he doesn't often deal with these issues in the context of breastfeeding. So I'm not taking his word as final. Another option is to wait six months and see if and how the mass progresses.

Given what might be at stake I don't feel comfortable with the wait and see approach.

Yesterday afternoon my records were faxed to Georgetown Hospital's breast surgeons who will review my films and provide a second opinion on how best to move forward.

Has anyone else had a core biopsy while nursing? Were you able to work around the post-op protocol to maintain your nursing relationship?

I'm so sorry to read this. As if you don't have enough on your plate at the moment! I don't have any experience to share, but I just want you to know my thoughts are with you. I do know that most of the time these small masses turn out to be nothing, but I can't imagine your worry. Hopefully you will get some answers (and good news) quickly.

I'm so sorry you are going through this. I have no experience to help you with, but I'm thinking about you and hoping things turn for the better quickly. I started crying the second I read about you telling your husband to get remarried. I feel the same way, it would be so hard to imagine my kids without a mother. Good luck.

Thanks everyone :) I know that statistically the odds are in my favor that everything is fine. Still, I've heard so many stories of crazy things happening to women our age and I can't help but feel a little on edge. Honestly, right now I'm just trying to get a better understanding of how this biopsy might impact nursing. I've read varying accounts and the doctors acted like it would be against their advice to nurse at least on the side of the biopsy, but even at all for several days afterward(because their protocol is to bind both breasts). Like I said, the doc seemed unfamiliar with this sort of thing in a breastfeeding mom, and all of these variables have to be weighed out. I would rather forgo the binding have more swelling, and be able to feed my child. Or the risk of bloody milk, I guess I would have to see how much blood before I just gave up. Or painful nursing, I've done that before and I would want to be the one to make the call. I'll learn more on Friday.

Jac,Send me a message on Tues..I'll try and contact Josie Tullo. An LC of many years. I'm sure she has come across this. I'm not sure why they would want both breasts bound if surgery is on one...You also need to find out post op meds...that would be of concern, although there is very little that you can't breastfeed with.Text me tues( to remind this old brain of mine)..xoox